Thrombectomy
What is Thrombectomy?
For years, the go-to treatment for stroke has been tissue plasminogen activator (tPA), a clot-busting medication that can break up dangerous stroke-causing clots in the blood vessels and arteries. When administered within four and a half hours of stroke symptom onset, tPA is largely effective at stopping a stroke and reducing complications.
Additional therapy is often needed with severe strokes that occur in large arteries. In these cases, thrombectomy (or mechanical thrombectomy) can improve outcomes.
During thrombectomy, the fat and cholesterol blocking the artery isn’t broken up or dissolved. Instead, it’s surgically removed, so blood flow is restored and the blockage is prevented from causing future problems.
In addition to stroke, thrombectomy is used to treat other conditions caused by blood clots, including deep vein thrombosis, heart attack and pulmonary embolism (blood clot in the lung).
Before Thrombectomy
Thrombectomy isn’t for all ischemic stroke victims. For thrombectomy, the stroke must occur in a large artery, where the most debilitating and deadly strokes occur. To be a candidate for thrombectomy, you must experience an ischemic stroke, which results from a blood clot.
Prior to the procedure, you must first receive tPA therapy. And, like tPA, thrombectomy is only beneficial within a small window of time. Currently, the surgery must take place within six hours of the onset of stroke symptoms. After that window, the procedure is not offered. As with all stroke therapies, the faster you undergo tPA and thrombectomy, the better.
During Thrombectomy
The procedure begins with the insertion of a catheter into an artery in the groin. This thin, flexible tube is carefully guided by the surgeon to the blocked artery in the brain.
Once the catheter is in place, a tiny tool is extended. The surgeon uses this tool to grab and retrieve the blockage. In some cases, a suction device may be used in removing the clot. The catheter is then withdrawn, and the incision site closed.
After Thrombectomy
During the first six months after your procedure, you may be prescribed blood thinning medication. These prevent clots from forming immediately after the procedure, ensuring proper blood flow and a successful procedure.
After removing the clot, your medical team watches over you in the hospital for a few days. In some cases, thrombectomy prevents long-term complications. When stroke complications are present, therapy begins during hospitalization to reduce their severity.
If needed, outpatient physical therapy services are available after returning home to help patients regain function or learn workarounds for any motor skills lost to stroke.